$boxers fracture$

#Boxers fracture series

Plain radiography of the left hand, including posteroanterior, lateral, and oblique views, is obtained. While CT and MRI may be utilized to evaluate for specific injuries of the hand and wrist (e.g., occult scaphoid fracture) in the outpatient setting, these are of limited utility in the acute setting for suspected metacarpal fractures. While US has potential for evaluating suspected hand fractures, further study is needed in the pediatric population.Ĭomputed tomography (CT) and magnetic resonance imaging (MRI) Several studies in the adult population have obtained similar results large prospective studies in the pediatric population are lacking. In another study of approximately 200 children aged 2 to 17 years, reported sensitivity and specificity for detecting hand fracture by US were 91% and 97%, respectively. However, patients included in this study were all over the age of 14 years. In one prospective study, US identified 38 of 39 fifth metacarpal fractures with a sensitivity of 97.4% and a specificity of 92.9%. US has become increasingly utilized in the acute care setting to identify fractures in the adult population. If there is question regarding the presence of a fracture, comparative hand imaging may be employed but is rarely necessary. The physis is a vulnerable location in pediatric bones, particularly in young children, who tend to injure the physis by shear forces, whereas older patients (such as adolescents) tend to have compressive injuries, preserving the physis and injuring the shaft. If clinically indicated, appropriate radiographs of the wrist, forearm, and elbow should also be obtained.Ĭonsideration should be given to physeal injuries when reviewing pediatric hand imaging. Plain radiographs of the affected hand are generally sufficient to identify the degree of metacarpal injury.

$boxers fracture$

Intraarticular extension or involvement of a growth plate should also be noted. Important considerations are the degree of angulation, any associated injuries, and if rotation is present, as rotational deformities can result in significant long-term deformities.

#Boxers fracture series

However, he was not seen the first time because he and his parents felt the injury was minimal but they both want to make sure that “nothing is broken this time.”Ī complete hand series consisting of posteroanterior (PA), lateral, and oblique views is standard when evaluating pediatric hand injuries. This is the second time he has sustained this injury. He did this several hours ago and his only complaint is medial hand pain he denies digit, wrist, forearm, or elbow pain. A 15-year-old male presents with left hand pain after becoming angry and punching a wall.

$boxers fracture$